ジュウジョウ　ケンタロウ   JUJO Kentaro   重城　健太郎    所属   埼玉医科大学  医学部 総合医療センター　心臓内科    職種   教授
論文種別	学術雑誌(原著)
言語種別	英語
査読の有無	査読なし
表題	Prognostic impact of additional mineralocorticoid receptor antagonists in octogenarian heart failure patients.
掲載誌名	正式名：ESC heart failure
巻・号・頁	7(5),2711-2724頁
著者・共著者	Takuro Abe,Kentaro Jujo,Motoko Kametani,Yuichiro Minami,Noritoshi Fukushima,Katsumi Saito,Nobuhisa Hagiwara
発行年月	2020/10
概要	AIMS: Guideline-directed medical therapy (GDMT) including beta-blockers and renin-angiotensin system inhibitors is shown to reduce mortality risk in patients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF). However, there is little evidence about the efficacy of additional administration of mineralocorticoid receptor antagonists (MRAs) with GDMT in patients ≥80 years presenting with HF. We aimed to investigate the prognostic impact of GDMT with MRA in relation to the age of patients with HF. METHODS AND RESULTS: This observational study included patients admitted for HF with reduced LVEF who were discharged alive; among them, 224 patients were ≥80 years, and 661 patients were<80 years. Both populations were divided into three groups depending on whether they received GDMT with or without MRA or single/no GDMT drugs (GDMT+MRA+, GDMT+MRA-, or non-GDMT, respectively). The primary endpoint was all-cause mortality. In patients ≥80 years, all-cause mortality was the lowest in the GDMT+MRA+ group (log-rank trend, P = 0.034), and no significant differences were observed between the GDMT+MRA- and non-GDMT groups. Multivariate Cox regression analysis reve
DOI	10.1002/ehf2.12862
PMID	32860346